Intended for healthcare professionals


Never underestimate the force of reproduction

BMJ 2000; 321 doi: (Published 19 August 2000) Cite this as: BMJ 2000;321:461

Effective contraception for teenagers requires a change in medical culture

  1. Basil Donovan, clinical professor (
  1. Department of Public Health and Community Medicine, University of Sydney, Sydney Hospital, PO Box 1614, Sydney NSW 2001, Australia

    Papers p 486

    Whether you give weight to the philosophy of a divine human spirit or to the elegant chemistry of evolution, or to both, there is no argument about humankind's drive to reproduce. The strength of that drive manifests in many ways: physically, as the millions of spermatozoa launched with each ejaculation; behaviourally, as the early onset and frequency of sexual activity; institutionally, as the papal preclusions of contraception and abortion; and professionally, as the trivialisation of sexual medicine and fertility control. It was no accident that the first drug to be overtly rationed by the NHS was sildenafil (Viagra). Sexual function was dismissed as a “lifestyle option” rather than an issue of health and wellbeing. But, while sexual intercourse occurs less often, the proportion of humans who will have sex during their lives approaches the proportion that will breathe.1

    Typically, young women who are adequately nourished are fertile. Globally, increasing numbers of young women are becoming sexually active long before they form durable partnerships.2 Access to contraception is essential but it may not …

    View Full Text

    Log in

    Log in through your institution


    * For online subscription